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COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY <br />Qa <br />'~`;a;°~' 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567 <br />6~ <br />rn ¢- <br />RE~~~V~~ <br />APPLICATION FORM FOR A REVISION MAY 0 g ?001 <br />TO A COAL MINING AND RECLAMATION PERMIT?;v;slon or q„ <br />Mining a °f3maticn <br />This form must be completed and submitted with all requests for minor revisions, as defined in ~~f4t)i4(73), <br />technical revisions, as defined in Rule 1.04(136), and permit revisions, as defined in Rule 1.04(90). All envisions <br />an: to address the requirements of Rule 2.08.4. Three (3) copies of the revision, induding maps, must be <br />submitted in order for tt to be complete. <br />All revisions are to be formatted so they pn be inserted imo the permit to replace the revised sections, maps. <br />tables and/or figures, with a revised ~ of cements, iF necessary. The revision submittal date should be printed <br />in fhe bwer right comer of each revision page. A cover letter to the revision should explain the nature of the <br />revision and reference the spedfic permit sections being revised. <br />For federal mines, a copy of the revision application must be submitted to ail agendas on the federal mailing list <br />(except OSM) at the same tune the appticetiorr is submithed to ttre Divisan, and proof of distribution must be <br />submitted to the Divisiwi along with the application. Copies of revision pages modified during the review process <br />must be disfn"buted in the same manner, along with proof of distribution. Proof of distribution must be sutxnitted <br />prior to implementation of the envision. <br />PermitNo.: C- ~ - B l~ Date: S l 08 /Zoo <br />Permittee: .~a_cinJ >Q(?5eu./~czS ~ilG <br />e ~ /N e <br />street: ~ Nor .as c ~~e ~v~ <br />/Y ~ Floc/' <br />city: o o~'~f- ~ .s r <br />State: ~~ Zip Code; 8~ D 3 _ <br />Brief Description of Revision: .~ocw.'f7ek~.of c~c~i~orta.Q ~-~~Ia.~ <br />~P~ 1M2/1,iccue L..JPJ~~S Gyi1Jz;~r ~C <br />r <br />DC~~LPIS I-I,tll'~ALUAGR-- A~L~• <br />Public Notice Attached: Yes - No Y ' (Requited for PRs and TRs) <br />Sond increase: Yes - No ~ Federal ~ Non-Federal - Mirte <br />Proposed Change in: <br />Permit Area - <br />Disturbed (+/--) - - ~ - d Acres <br />Permit (+/-) - - !Z . v Aries <br />Affected (+/-) - _ ~ . r~Acres <br />Mineral Ownership - <br />Mineral Private (+/-) - - Q . D Aces <br />Mineral Federal (+/_) - - ~ . Q Acres <br />Surface Ownership - <br />Private Land (+/_) _ - ~ . a Acres <br />Federal Land (+/-) - _ ~ . o Acres <br />State Land (+/-) - _ o . o Acres <br />Mineral State (+/-) - _ f1. O Acres <br />